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World will lack 18 million health workers by 2030 without adequate investment, warns UN

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i5169 (Published 22 September 2016) Cite this as: BMJ 2016;354:i5169
  1. Matthew Limb
  1. London

A United Nations commission has called for urgent global investment to create new health sector jobs and prevent a projected shortfall of 18 million health workers by 2030.

It said that these health workers will be needed mainly in low and lower middle income countries to meet population needs, achieve universal health coverage, and spur economic growth. Without adequate investment, it warned, “inequalities will rise, and social cohesion will be adversely, even catastrophically, affected.”

The Commission on Health Employment and Economic Growth is chaired by the French president, François Hollande, and the South African president, Jacob Zuma. It submitted a report, including 10 recommendations for action, to the UN secretary general, Ban Ki-moon, at the UN General Assembly in New York on 20 September.1

The report said that demand for health workers was growing as populations aged and rates of non-communicable diseases increased.

The global economy is projected to create around 40 million new health sector jobs by 2030, which would represent a “doubling of the current global health workforce.” But most of these jobs will be created in the wealthiest countries, leaving a shortfall of 18 million health workers, mainly in low and lower middle income countries, the commission warned.

It said that investment in the health workforce was needed to make progress towards sustainable development goals, including gains in health, global security, and “inclusive” economic growth. The commission noted evidence that investing in health stimulated growth and the “economic empowerment of women and youth.”

An estimated one quarter of economic growth from 2000 to 2011 in low and middle income countries resulted from the value of improvements to health, the report said.

Margaret Chan, director general of the World Health Organization, said, “For too long countries have seen health workers as just another cost to be managed, instead of an investment with a triple return for health, economic growth, and global health security.”

The 10 recommendations include “stimulating investments in creating decent health sector jobs, particularly for women and youth, with the right skills, in the right numbers and in the right places.”

The commission also called for more health workers in prevention and in community based and primary care, paying special attention to “underserved areas.” Other proposed actions include tackling gender biases and inequities in education and the health labour market, to foster women’s empowerment.

The report said that adequate funding should be raised from domestic and international sources, both public and private, and that more should be done to improve the quality of education and lifelong learning.

The commission also recommended more work to understand workforce migration to maximise benefits and ensure that countries are not disadvantaged. It said that investing in health workers was one part of the broader aim of strengthening health systems and social protection, constituting the “first line of defence against international health crises.” The Ebola outbreak in west Africa had shown how “inaction and chronic underinvestment can compromise human health, and also lead to serious economic and social setbacks,” the report said.

Guy Ryder, director general of the International Labour Organization, welcomed the commission’s “practical” proposals towards achieving the 2030 agenda for sustainable development, including sustainable development goal 8 on “inclusive growth and decent work.”

The vice chairs of the commission, from WHO, the International Labour Organization, and the Organization for Economic Cooperation and Development, will convene “all relevant stakeholders” by the end of 2016 to develop a five year implementation plan.

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